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THE
SELECTIVE
MUTISM
RESOURCE MANUAL
SECOND EDITION
A Speechmark Book
MAGGIE JOHNSON
& ALISON WINTGENS cc e
ss
a
l i ne ing
s on port ls
e p ia
c lud to su ater
In m
The Selective Mutism Resource Manual –
Access your online resources
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designed to ensure this resource best supports your needs.
Activate your accompanying online resources:
• Go to www.routledge.com/cw/speechmark then click on the cover of this book
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accompanying online resources
THE
SELECTIVE
MUTISM
RESOURCE MANUAL
SECOND EDITION
MAGGIE JOHNSON
AND ALISON WINTGENS
LONDON AND NEW YORK

Courage is resistance to fear, mastery of fear – not absence of fear.
Mark Twain (1835–1910)
Notes on the text

• Please note that, throughout this manual, the abbreviation ‘SM’ is used to refer to ‘selective mutism’.
• We often specify which age group we are talking about (early years, younger children, adolescents or
teenagers) but ‘child’ or ‘children’ is used where it is intended to be fairly general.
• ‘Parent’ refers to parent or guardian.
• ‘Practitioner’ refers to any therapist, psychologist or clinician working with the child and their family.
Dedications
To my Little Wurrit, who turned out to be the bravest of us all.
To Peter for his support, encouragement and patience.
First published in 2016 by Speechmark Publishing Ltd
Published 2017 by Routledge

2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA
Routledge is an imprint of the Taylor & Francis Group, an informa business
Copyright © Maggie Johnson & Alison Wintgens, 2016
All rights reserved. The purchase of this copyright material confers the right on the purchasing institution to photocopy pages
which bear the Photocopy icon and copyright line at the bottom of the page. No other parts of this book may be reprinted
or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information storage or retrieval system, without permission in writing from
the publishers.
Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation
without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN 978 1 90930 133 7 (pbk)

CONTENTS
Contents
Foreword by Hanne Kristensen vii
Preface viii
Authors’ acknowledgements x
List of tables xi
List of figures xii
List of boxes xiv
List of online resources xv
Part 1 Understanding Selective Mutism

Chapter 1 Frequently asked questions about selective mutism 5
Chapter 2 A holistic view of selective mutism 29
Part 2 Guidelines for Identification and Assessment

Chapter 3 Making a diagnosis: what we need to know and why 53
Chapter 4 The core assessment: initial information gathering 63
Chapter 5 Meeting and involving the child or young person 69
Chapter 6 The extended assessment: further information gathering 93
Chapter 7 Moving from assessment to management 101
Part 3 Management
Chapter 8 Ensuring an anxiety-free environment: the starting point for home
and school 115
Chapter 9 Facing fears at home and in the community 143
Chapter 10 Facing fears in educational settings 175
Chapter 11 Making successful transitions 235
Part 4 Reflective Practice: Learning from Experience

Chapter 12 Troubleshooting: why isn’t it working? 257
Chapter 13 When it is more than selective mutism 267
Chapter 14 Examples of interventions 289
Chapter 15 Learning from people who have experienced selective mutism 311
Index 327
Part 5 Online Resource Library

Appendix A Activities to develop confident talking 343
Appendix B Establishing speech using telephone, lone talking and shaping
programmes 379
v
THE SELECTIVE MUTISM RESOURCE MANUAL
Appendix C Examples of programme targets, recording systems and individual

education plans 395
Appendix D Legal, professional and educational support 413
Appendix E Evidence base and references for The Selective Mutism
Resource Manual (second edition) 429
Appendix F Resources and useful contacts 445
Handouts 453
Booklet for Teenagers and Adults 505
Forms 519
Progress charts 575
References (research references – see Appendix E;
resource references – see Appendix F)
vi
Foreword
FOREWORD
Twenty years ago, I met the first child with selective mutism (SM) in my clinical practice. I still remember the
unpleasant feeling of incompetence and the literature gave few answers. This triggered me to start researching SM for
the next two decades.
In 2016, the literature and knowledge about SM have improved considerably, and there is greater agreement among
clinicians on how to understand and treat the condition. Maybe the most important progress has been to categorise SM
as an anxiety disorder. Nevertheless, it is still a challenge to offer adequate help for these children.
This excellent resource manual presents updated information on important aspects of SM and – above all – practical
and detailed information on how to deal with the problem that is relevant for clinicians, teachers, children and
adolescents with SM and their family members. It also provides lots of useful handouts. The case stories are
representative, illustrate the variation of symptoms in SM and emphasise the importance of tailoring interventions for
each child.
The two authors have an extensive and unique experience with children and adolescents who have SM, and their deep
respect for each individual is reflected in all of the chapters. They also address muteness in all relevant arenas and the
impact on important people in each child’s life. This is essential for treatment success and is a clear message to our
colleagues not to restrict their intervention to clinical settings.
This book contains a wealth of knowledge!
Hanne Kristensen, MD, PhD

Centre for Child and Adolescent Mental Health
Southern and Eastern Norway
(March 2016)
vii
PREFACE
Despite more parent organisations, training, books, research and media coverage in the last 15 years, selective mutism
(SM) continues to be a misunderstood condition. However, its importance is as great as ever for several reasons.
Children who have SM are at a significant disadvantage both personally and socially. SM is a great barrier to learning
and, if neglected or mismanaged, it may continue into adulthood with devastating effects. Yet SM is hidden and easily
overlooked – ‘the quiet child is the forgotten child’ – and more attention and resources are directed towards children
who are disruptive. Different disciplines may not agree on who should take responsibility for it; and many professionals
do not have adequate training or see enough children who have SM to build up much experience.
SM has a significant and powerful effect on other people around the child, especially parents and teachers. The very
nature of SM disrupts the normal process of interaction; and it is unnerving and even threatening when attempts to
draw out a child are apparently rejected. It is our experience that people encountering SM for the first time rarely have
sufficient information to feel confident about how to manage the child or put a treatment programme into practice, even
when they are familiar with the principles involved. Furthermore, parents and professionals are sometimes afraid to
intervene, in case they make the situation worse.
The earlier the situation can be addressed, the better for everyone involved.
When we met, both speaking about SM at an international conference in York in 1999, we decided to pool our
experiences and perspectives as two speech and language therapists working in two different services: child and
adolescent mental health and community health. We wanted to set out practical assessment and treatment, advice
and information on how to identify and manage SM that was accessible for parents and a range of professionals. The
result was the first edition of The Selective Mutism Resource Manual, published in 2001. Now, 15 years later, we have
a total of over 60 years of working alongside several hundred children and young people with SM, directly and through
supervision, acting as advisers, running parent groups, and teaching both in the UK and overseas.
Our ideas have inevitably developed but our approach has not changed fundamentally. This second edition of the
manual is again based on the importance of having a good understanding of the nature of SM to create the right
environment to manage it wisely; and the behavioural principles for building graded exposure programmes within a
broader model of confident talking.
Part 1 starts with an expanded ‘frequently asked questions’ chapter which signposts you to other sections in the
manual; the second chapter explains the rationale and framework for our methods in the light of research findings
and our clinical experience. Parts 2 and 3 again give detailed ideas on assessment and management, respectively.
You will see more emphasis on how parents can help their children; informal approaches for round-the-clock support;
a fuller look at understanding and managing anxiety; new handouts, forms and checklists for you to access and print;
and additional materials for older children and young people. We focus on home, community and educational settings,
rather than clinical settings. This is because we believe that these are the environments where clinicians need to focus
their involvement, either through direct work with the child or by supporting the child’s family and school.
viii
Preface
Part 4 begins with troubleshooting – practices that prevent or hinder progress. There is a chapter on identifying and
managing coexisting conditions alongside SM; and a chapter with examples of interventions with various children and
young people. The manual ends with insights and reflections from adults who have experienced SM in the past. We
recognise that attention now needs to turn to adults who still have SM.
Please don’t be put off by the size of this manual – you don’t have to read it all! It remains a resource manual,
written for a wide range of people, including teachers, clinical and educational psychologists, speech and language
therapists, child psychiatrists and importantly parents, and young people and adults who have SM. It contains a lot of
material which you can dip into, whichever part suits and helps you best. For example, you might start with Chapter 1
‘Frequently asked questions’ or head for Part 2 on assessment. The parental interview forms are more suitable
for clinicians, whereas the advice in ‘Ensuring an anxiety-free environment’ and ‘Facing fears at home and in the
community’ has a much wider application.
We recommend that you access and print any online resources that are relevant to your situation and the age of your
child or young person. Schools or teams managing a caseload may prefer to print out all of the resources and keep them
in an accompanying file for ease of access. With different readers in mind, we have aimed for a style that is appropriate
for everyone. Whoever you are, we hope that this manual gives you a better understanding of SM and the confidence
and tools to help alleviate it.
Maggie Johnson and Alison Wintgens

(March 2016)
ix
AUTHORS’ ACKNOWLEDGEMENTS
This book could not have been written without all the children, young people and parents with whom we have had
the privilege to work. We have learned so much through them and are sure they will recognise their contributions
throughout this manual. We are also most grateful to the adults who have shared their experience of SM with us and
generously provided feedback as we wrote the manual or allowed their stories to be published here.
We have also benefited from the shared knowledge and practice of good colleagues and professionals we have worked
alongside or been fortunate to meet. Although there are too many to name individually, after so many years in the field,
we would like to especially mention Una Freeston and Peter Hill, to whom we dedicated the first edition, ‘for their
wisdom and the ability to communicate it’. Their inspiration lives on!
Last but not least, we would also like to thank our immediate and wider families and close friends for encouraging,
supporting and bearing with us while we were writing this second edition.
x
List of Tables
LIST OF TABLES
5.1 Confident talking – the stages of one-to-one interaction 74
6.1 Confident talking – the stages of one-to-one interaction related to assessment 96
7.1 The progressions of confident talking 108
8.1 Confident talking – building rapport on a one-to-one basis 124
8.2 Possible maintaining factors with alternative management strategies 134
9.1 Confident talking – establishing speech on a one-to-one basis through shared

activity in natural settings 151
9.2 Talking in public places – community settings 167
10.1 Summary of low- and high-risk activities 178
10.2 Confident talking – establishing speech with young children on a one-to-one basis
using informal shaping activities 183
10.3 Confident talking – establishing speech on a one-to-one basis through friends

the child talks to easily 185
10.4 Classification of activities by level of risk (anxiety load) 193
10.5 Talking in public places – educational settings 205
10.6 Confident talking – working towards effective social functioning 211
10.7 Categorisation of unhelpful thinking patterns 228
10.8 Reframing unhelpful thoughts 229
xi
LIST OF FIGURES
2.1 Factors contributing to the development of selective mutism 37
2.2 Summary of factors contributing to the development of selective mutism 37
2.3 How pressure and avoidance contribute to selective mutism 40
2.4 Development and implementation of an effective multi-agency care

pathway for selective mutism 43
2.5 A multidimensional model of confident talking 47
3.1 Flow chart for lay diagnosis of selective mutism 57
3.2 The assessment framework 60
5.1 Making a talking map 77
5.2 ‘The best school in the world’ 78
5.3 Learning about phobias 83
5.4 ‘Kitten Phobia’ by Greg Sherrer 84
5.5 Establishing a young person’s priorities 88
5.6 Establishing priorities, using sorting and ranking 89
5.7 Exploring the young person’s self-perception, using a rating activity 91
7.1 Planning intervention: overall strategy and team building 105
7.2 Confident talking – a model for balanced intervention 106
7.3 Confident talking – the generalisation process 107
8.1 Drawing up an action plan 116
8.2 Selective mutism awareness cards 118
8.3 Examples of pictorial rating scales to express emotions 126
8.4 Communication chart 127
8.5 Working towards initiating contact at school 128
8.6 What are you thinking? 132
9.1 Using the model of confident talking to consider speaking habits 145
9.2 Introducing questions to a person with selective mutism 153
xii
List of Figures
9.3 Using a talking bridge to accelerate one-to-one interaction 153
9.4 The Triangle Tactic 156
10.1 The mechanics of voice production 218
10.2 Example of breaking down a situation to identify the source of anxiety 222
10.3 Exploring communication styles 224
11.1 Introducing a child who has selective mutism 237
xiii
LIST OF BOXES
Box 2.1 Essential characteristics of SM behaviour as described by DSM-5 and ICD-11 Beta-draft 30
Box 2.2 Essential characteristics of specific phobia as described by DSM-5 and ICD-11 Beta-draft 31
Box 2.3 Avoidance behaviour in SM 35
Box 2.4 Summary of SM maintaining factors 39
Box 7.1 Overall management progression 103
Box 9.1 Fostering friendships 154
Box 9.2 Example of telephone homework 165
Box 9.3 Helping children who have SM to face and cope with social events 168
Box 9.4 Progression to re-establish speech with a talking partner such as a parent 173
Box 10.1 Home visits for younger children 181
Box 10.2 What makes a good keyworker? 189
Box 10.3 ‘My Story’ script 208
Box 11.1 Sample letter from professional to primary school SENCo about
secondary school transfer 242
Box 11.2 Sample education plan for transition to secondary school 244
Box 11.3 Sample moving on plan written by a teenager with adult support and made
available to college before transition 245
xiv
List of Online resources
LIST OF ONLINE RESOURCES

Handouts
1 Talking to the child about speech anxiety – ‘the pep talk’ 453
2 What is selective mutism? 454
3 Quiet child or selective mutism? 456
4 What to say when … 458
5 Selective mutism is a phobia 460
6 Firm foundations: building confidence, courage and self-esteem 461
7 Helping children to cope with anxiety 464
8 Mistaeks happen …! 468
9 Helping young children to speak at school 470
10a Ensuring an anxiety-free environment for children who have selective mutism 473
10b Ensuring an anxiety-free environment for young people who have selective mutism 476
11 Enabling quieter students to communicate 479
12 Do I answer for my child? 481
13 Easing in friends and relatives 483
14 Talking in public places 488
15 The informal Sliding-in Technique 493
16 The Sliding-in Technique 495
17 The Sliding-in Technique using telephone handsets 501
18 The reading route 503
Booklet for Teenagers and Adults

When the words won’t come out (easy-to-read A4 version) 505
When the words won’t come out (A5 print version) 513
Forms
1a Parent interview form 519
1b Extended parent interview form 524
2a Primary school report form 536
2b Secondary school report form 542
xv
3 Record of speaking habits 548

4 Checklist of possible maintaining factors 549
5 Picture this …! 551
6 Young person’s interview form 552
7 All about me 556
8a Primary communication rating scale 557
8b Secondary communication rating scale 558
9 Worrying thoughts 560
10 Reactions of family/friends/staff 563
11 Selective mutism: assessment and management checklist 565
12 Environmental checklist for educational settings 567
13 Environmental checklist for home setting 569
14 Target sheet and action plan 570
15 Talking to strangers (for older children and teenagers) 571
16 Staff questionnaire 573
Progress charts
1 One-to-one interaction with a range of people 575
2 Talking in public with increasing numbers of bystanders 577
3 Record of individual/group sessions 578
4 Talking to a new person using the Sliding-in Technique 579
5 Generalising speech from one-to-one interactions to the classroom 580
6 Record of independent social functioning and assertiveness 582
xvi
PART 1
UNDERSTANDING
SELECTIVE MUTISM
CONTENTS
Understanding Selective Mutism

Chapter 1 Frequently asked questions about selective mutism
Introduction 5
Frequently asked questions 5
Chapter 2 A holistic view of selective mutism

Introduction29
The nature and presentation of SM 30
What causes SM? 36
Implications for multidisciplinary ownership of SM 42
The importance of early intervention 44
Rationale and framework for our treatment approach 46
3
1
CHAPTER 1
FREQUENTLY ASKED QUESTIONSABOUT
Frequently asked questions

SELECTIVE MUTISM
Introduction
Despite a significant increase in awareness and professional interest since the first edition
of this manual, there is still much misunderstanding and disagreement about the nature of
selective mutism (SM). In order to treat any condition effectively, it is important to know
what we are dealing with and to dispel some of the myths. This chapter begins by listing
the frequently asked questions about SM. The answers that follow will direct you to various
sections of the manual or the online resource library for further reading.

1 Does my child have SM?
2 Some children are just shy. How can I tell the difference?
3 Can’t speak or won’t speak?
4 Won’t they just grow out of it?
5 What causes SM?
6 No child of mine would behave like that – why do parents put up with it?
7 Isn’t this child just being stubborn?
8 The child was smirking at me – what’s that about?
9 Is SM about having control?
10 Have children who have SM been traumatised or abused?
11 My child can talk at school so I was told it can’t be SM. Is that right?
12 My child has stopped talking at playgroup. Is it SM?
13 My child does not talk at all. Does that rule out SM?
14 Why has my child stopped talking to the family too?
15 My child is getting increasingly resistant to everything, not just talking.
What can I do?
16 Is it advisable to separate twins so that the one who has SM can’t lean on
the other?
17 My child found school much too stressful. Am I right to consider home-schooling?
18 Why does my child talk to strangers but not people he knows well?
19 My child is making progress but doesn’t talk if I’m around, Why is that?
20 Should we be more protective of children who have SM?
21 How common is it?
22 At what age does it start?
5
23 Do I need an official diagnosis?

24 If I need an official diagnosis, who would do it?
25 My child was referred to speech and language therapy. Isn’t SM a psychological problem?
26 At what point should action be taken?
27 Why is early intervention so important?
28 Is it too late to help teenagers and adults who have SM?
29 Nothing has worked so far. Why should it be different this time?
30 What form will intervention take?
31 What about medication?
32 Who should be involved in intervention? Do we need an expert in SM?
33 How long will intervention take?
1 Does my child have SM?
The essential feature of SM is that, in certain situations, the child speaks little or not at all while, in
other situations, they are uninhibited and talk freely. The pattern is predictable and has persisted for at
least a month (two months in a new setting such as school). Beyond this, no two children who have SM are
exactly alike.
After many years of misunderstanding, SM is now recognised as an anxiety disorder. This does not
mean that your child is anxious all the time; it’s at specific times when they sense an expectation to
speak that their anxiety levels shoot up. For example, it may be easy to talk to parents in a large, noisy,
impersonal supermarket but impossible in the corner shop where every word can be heard. Suddenly
their body and face stiffen and their communication becomes non-existent or reduced to whispers,
single words, short phrases or simple gestures. Similarly, a child may talk happily to their friends in
the playground but clam up as soon as a teacher approaches. Everyone involved becomes expert at
predicting what will happen in each situation the child is exposed to. This is very different from the
‘mood-dependent’ communication of emotionally disturbed children and typical teenagers which can
vary on a daily basis.
Nothing characterises SM more than the sudden swings from relaxed and chatty, to wary and reticent
as the child becomes aware of another person’s presence. But only people in the child’s comfort zone
will see these swings; others only see a quiet child and may not even realise that the child speaks at all.
If your child does not present these marked changes, or talks on some days but not others in identical
circumstances, they are unlikely to have SM.
Below are a few final points to consider.
★ SM may exist alongside other diagnoses or considerations.
★ SM may be confused with other diagnoses.
6
★ The presentation of SM changes over time, and a child may also stop talking at home.
★ Short-lived or isolated episodes of silence do not satisfy the criteria for SM.
★ SM does not only affect speech. Children can become so anxious about talking that extreme muscular
tension can interfere with their ability to point, handle objects, walk or run.
Chapter 1 ‘Why has my child stopped talking to the family too? (page 15)
Chapter 1 ‘Do I need an official diagnosis?’ (page 21)
Chapter 3 ‘Making a diagnosis’ (page 53)
Chapter 13 When it is more than selective mutism
Online: Handout 2 ‘What is selective mutism?’
2 Some children are just shy. How can I tell the difference?
Children who have SM appear to be shy in many situations but are not necessarily shy by nature, as their
families will confirm. They may appear very confident when there is no need to talk. But they become
immediately tense and unresponsive when questioned by people outside their comfort zone, which does not
abate until the pressure to talk has been removed.
Shy children may be worried about speaking; children who have SM are terrified.
Shy children are generally unsure of themselves, slow to warm-up and slow to come forward, but they
do not display the extreme aversion to speaking that characterises SM. Their facial expressions and body
language convey uncertainty and hesitation rather than an unyielding stare and stiffness. With gentle
support and encouragement, they gradually get used to new situations and new people, and talking comes
as a natural part of gaining confidence and getting involved in activities. Having settled into school or
nursery (this can take up to a month), shy children may still find it difficult to initiate interaction, but they
are able and usually glad to respond if someone else makes the first move. Their expressive language will
be no different from how they speak at home.
It is important to note that shy children may develop SM if they are subjected to ridicule or pushed into
speaking before they are ready. Therefore all shy children and reluctant speakers need support and
reassurance to settle in and participate at their own pace.
Chapter 1 ‘My child can talk at school so I was told it can’t be SM’ (page 13)
Online: Handout 3 ‘Quiet child or selective mutism?’
Handout 9 ‘Helping young children to speak at school’
7
3 Can’t speak or won’t speak?
Children who have SM speak happily to some people but clam up as soon as others enter the room. The
stony look on their face can give the impression that their silence is deliberate, even defiant, and that the
child is refusing to speak to certain people. This leads to remarks such as ‘He’ll speak when he wants to’
and ‘If she can’t be bothered to talk to me, why should I talk to her?’
Understanding that selective mutism is a phobia is an important first step to

providing sympathetic and appropriate support
Everyone can withhold speech out of choice, but it is generally

Emma’s teacher was frustrated:
‘She’s taking us all for a ride. She short-lived and feels nothing like being unable to speak. Children
loves her daily session with the who have SM want to speak but have an irrational fear or dread – a
classroom assistant, but will only phobia – of speaking aloud in certain situations: when expected to
draw pictures or play. As soon as any speak, they inwardly panic, become physically frozen and cannot
speech is required, she digs in her utter a sound (similar to stage fright). The panic sensation is so
heels and refuses.’ distressing that they will go to great lengths to avoid it, including
trying to prevent certain people finding out that they can speak.
It’s not that they ‘won’t’ speak; they simply can’t face what happens to them when they try. Other forms
of avoidance may include the use of alternative forms of communication such as gesturing, whispering,
writing or using a modified voice – if these are accepted in the long term, they can become ‘safe’ habits
which arouse no anxiety.
It is essential to regard and respond to SM as a phobia, rather than a choice to be silent.

Chapter 14 Examples of interventions (Daniel – whispering)
Online: Handout 5 ‘Selective mutism is a phobia’
4 Won’t they just grow out of it?
Do children outgrow their fear of the dark? It may seem like this but, in fact, it is sympathetic handling and
appropriate support that allows them to work through it. If they were repeatedly shut in a dark room despite
their fear, they would grow up with a deep dread of darkness and losing control.
So it is with SM. Some children are lucky enough to get the right support and the SM is resolved. However,
as SM is generally not well understood, many children are repeatedly put in situations where they are
encouraged to talk, followed by disappointment or disapproval when they do not. Their dread of talking
increases and their self-esteem, confidence, school work and friendships are all at risk. Left untreated for
many years, some will become adults with SM. The disorder may progress until the young person no longer
8
speaks to anyone, not even close friends or family. However,

No one had heard of selective mutism when
a good number work through their fears without formal I was little. All I remember is feeling really
intervention but inevitably experience much unhappiness afraid whenever someone came to our house
along the way. and hiding behind the dressing table in
my mother’s room. I knew my behaviour
Since there is no way to identify which children will receive was upsetting her but I didn’t know how
appropriate support or discover their own ways to face their to change.
fears, there is no guarantee that children will overcome
‘Luckily, I had a really understanding teacher.
SM. Therefore, all cases of SM should be taken seriously. She visited me at home and spent extra time
Timely intervention will result in positive changes almost with me at school. She didn’t push me to do
immediately. anything I couldn’t manage and gradually
I started joining in. By the time I was six or
seven, I was coping pretty well but there were
Chapter 1 ‘At what point should action be taken?’
still times I froze completely. It wasn’t until I
(page 22)
was a teenager that I realised something had
Chapter 2 ‘The importance of early intervention’ lifted and my anxiety about talking had gone.
(page 44)
Online: Booklet for teenagers and adults ‘When the words won’t come out’
5 What causes SM?
When children who have SM do not speak, one of two things is happening: either the prospect of speaking
in certain situations fills them with such dread that they are physically unable to speak; or they spare
themselves this intensely distressing experience by avoiding the need to speak. The more they experience
either of these scenarios, the more their fear of speaking is reinforced.
As with other phobias, there is no single cause of SM but there are three elements that contribute to the
process of ‘fear conditioning’: the child develops an irrational fear of talking that is triggered by specific
people and the expectation to talk.
1 A sensitive personality – a combination of genetic (inherited) and psychological factors make

individuals particularly vulnerable to developing anxiety disorders.
2 Life events establish a link between the need to talk and intense anxiety.
3 Maintenance behaviour – the reactions of other people reinforce and strengthen the child’s belief that
speaking is difficult, stressful and best avoided.
These three sets of contributing factors provide important clues to subsequent management of the
condition. However, while it is essential to identify and address maintenance behaviour, it is not always
necessary to pinpoint how or when the SM first started. Even more importantly, there is no need or value
in feeling responsible or attributing blame. SM can develop despite the best intentions to provide a safe,
loving and enriching environment.
9

Table 8.2 ‘Possible maintaining factors with alternative management strategies’ (page 134)
Online: Form 4 ‘Checklist of possible maintaining factors’
Form 10 ‘Reactions of family/friends/staff’
6 No child of mine would behave like that. Why do parents

put up with it?
SM is not caused by absent, ineffective or overindulgent parenting. Parents try their hardest to get their
child to talk but nothing works. Gentle encouragement, pleading, cajoling, insistence, threats, bribes,
rewards and punishments all make the child more afraid of speaking. SM is the result of a subconsciously
learned fear. The only way to overcome it is to unlearn this fear.
We don’t reprimand children who are afraid of the dark or force them
to sleep in a dark room.
To help understand, consider another common childhood anxiety – fear of the dark. Few children grow
up with a phobia of darkness because it does not require a course in parenting to handle the situation
appropriately. We recognise that offering a reward to endure a night without a light on is pointless; the
incentive offered could never outweigh the child’s genuine fear. We do not increase their anxiety by
punishing them, telling them off, or insisting that they stay in a dark room for hours with no escape. If
we did, we would soon see an increase in bed-wetting and insecurity during the day and have a fight on
our hands when it came to putting the child to bed every night. Instead we leave a light on. We provide
a sympathetic ear and talk openly about the child’s fears. We tell them we are not far away. We find
appropriate story books and tell them they won’t always be scared. And, rather than keeping things as
they are, we naturally implement a psychological technique called graded exposure. We progress from the
landing light to a glow-plug and close the door a fraction, all at the child’s pace, until eventually they get
used to being on their own in the dark. Exactly the same techniques work for SM.
Chapter 8 Ensuring an anxiety-free environment

Chapter 9 Facing fears at home and in the community
Handout 7 ‘Helping children to cope with anxiety’
7 Isn’t this child just being stubborn?
People frequently make comments such as ‘How does she manage to keep quiet for so long? She must
have incredible willpower!’ However, once SM is recognised as a phobia, such comments become as
10
nonsensical as ‘How on earth does she resist picking up spiders?’

Ian’s father commented: ‘I don’t
and ‘What incredible willpower to avoid flying!’ Phobic individuals know why he won’t give in. I’ve
do not stubbornly refuse to do the things they fear; they cannot promised him the bike he wants
face their fears, and cope through avoidance and more comfortable when he talks to his teacher, but he
alternatives. Similarly, children who have SM may remain silent but simply won’t do it. He’s so stubborn.’
that is not the same as ‘choosing’ to be silent or ‘refusing’ to speak.
If they had any choice in the matter, they would choose not to have SM.
If children can find a way to avoid anxiety, naturally they will take it. If successful, they will not be anxious;
just as adults with a phobia of flying are not anxious when they are not on an airplane. Consequently,
children with more strong-willed personalities may be adamant that they are not going to repeat an
experience which previously triggered a panic reaction, while those with more compliant personalities may
dawdle or beg their parents to be excused.
When sensing the genuine distress at the root of such demands, it is tempting to allow children to opt out
of activities completely. However, this is not helpful in the long term and only increases avoidance and fear
of speaking. It is essential to find ways for the children to participate in non-stressful ways.

Handout 7 ‘Helping children to cope with anxiety’
8 The child was smirking at me. What’s that about?
Just as children who have SM may be described as glaring, sullen or grumpy, they are often perceived by
their teachers and other people to be smirking. These children are simply caught in a tense, frozen moment
when they can neither smile nor grimace. Who knows what they are feeling? They could be trying to smile
to show willing; they could be feeling panicked; they could be experiencing relief as the spotlight moves
from them to another child. It is impossible to tell simply by looking …
None of us is as good at reading facial expressions as we like to think. Luckily, we usually have numerous
clues: we witness the full range of facial movement from start to finish; and match this to what the
individual is saying and how they are saying it in the context of a two-way conversation. However, these
clues are not available when observing a silent child who has a fixed expression. Coupled with a lack of
information and common misassumptions about SM, conclusions may be drawn which are detrimental to
the child. Ultimately, these conclusions could make or break the quality of that child’s experience of school
or other social settings, as they are bound to affect the adult’s attitude towards the child.
For a demonstration of how difficult it is to read facial expressions, go to http://greatergood.berkeley.edu/

ei_quiz/ and try the Body Language Quiz. Even people who achieve an above-average score are likely to
11
make several mistakes. The quiz shows how easy it is to get facial expressions wrong and how subtle the
differences are between certain expressions when there are no other contextual clues.
Chapter 5 Meeting and involving the child or young person

Chapter 8 ‘Sharing emotions’ (page 126)
Chapter 10 ‘Talking about feelings’ (page 220)
9 Is SM about having control?
Children who have SM are often said to be ‘very controlling’. Control and anxiety are closely linked, as
anyone with a ‘control-freak’ friend will know!
However, there is a difference between the control we need over our environment to keep anxiety at bay
and control that is driven by power-seeking. The former is part of our basic human need to feel safe and
secure. For example, we check that doors are locked, we prepare for an interview, we are reluctant to
delegate if we think that mistakes will be made.
Children who have SM need control in order to keep their anxiety at bay.
In exactly the same way, children who have SM take steps to

When she was little, Charlotte had
complete control over our whole manage their anxiety about speaking. Remembering their panic in
family. She wouldn’t speak to situations where they were expected to speak and the subsequent
anyone other than us [her parents] disappointment, embarrassment or humiliation when they could not,
and her brother, so I couldn’t leave it is natural to seek damage limitation. They do this in three ways:
her with any of my friends.
1 Through avoidance, as discussed in question 7.
She stuck to me like a limpet
and it was such a relief to find a 2 By finding out every detail of what is about to happen, so that
teacher who was prepared to build there are no surprises.
a relationship with her in our own
home. 3 By stipulating changes that make the situation more
manageable.
This is not manipulation or a need to dominate; it is how most people cope with anxiety. We need to give
children who have SM more control by involving them in agreeing appropriate modifications as we work
towards their full participation.

Chapter 10 Facing fears in educational settings
Online: Handout 7 ‘Helping children to cope with anxiety’
12
Another random document with
no related content on Scribd:
the earthly or material; and three Churches: the Chosen, the Called,
and the Captive[151].” The meaning of these names we shall see later
when we consider the Ophite idea of the Apocatastasis[152] or return
of the worlds to the Deity.
First, however, another Power had to be produced which should
serve as an intermediary or ambassador from the Supreme Triad to
the worlds below it. This necessity may have arisen from Plato’s
view, adopted by Philo of Alexandria, that God was too high and
pure to be contaminated by any contact with matter[153]. But it may
also owe something to the idea common to all Orientals that a king
or great man can only communicate with his inferiors through a wakil
or agent; and that this idea was then current in Phrygia seems plain
from the story in the Acts of the Apostles that in the Lycaonian
province Barnabas, who was of majestic presence, was adored and
nearly sacrificed to as Zeus, while Paul, who was the principal
speaker, was only revered as Hermes[154]. The later Ophite account
of the production of this intermediary power or messenger which we
find in Irenaeus is that the Father-and-Son “delighting in the beauty
of the Spirit”—that is of the First Woman—“shed their light upon her”
and thus brought into existence “an incorruptible light, the third man,
whom they call Christos[155].” With this last addition the Divine Family
was considered complete, and the same author tells us that Christos
and his mother were “immediately drawn up into the incorruptible
aeon which they call the veritable Church[156].” This seems to be the
first appearance in Gnosticism of the use of the word Church as
signifying what was later called the Pleroma or Fulness of the
Godhead; but it may be compared to the “Great Council” apparently
used in the same sense by some unidentified prophet quoted by
Origen, of which Great Council Christ was said by the prophet to be
the “Angel” or messenger[157].
From this perfect Godhead, the Ophites had to show the evolution of
a less perfect universe, a problem which they approached in a way
differing but slightly from that of Simon Magus. This last, as we have
seen, interposed between God and our own world three pairs of
“Roots” or Powers together with an intermediate world of aeons
whose angels and authorities had brought our universe into
existence. These angels purposely fashioned it from existing matter,
the substance most removed from and hostile to God, in order that
they might rule over it and thus possess a dominion of their own. But
the Ophites went behind this conception, and made the first
confusion of the Divine light with matter the result of an accident.
The light, in Irenaeus’ account of their doctrines, shed by the Father-
and-Son upon the Holy Spirit was so abundant that she could not
contain it all within herself, and some of it therefore, as it were,
boiled over and fell down[158], when it was received by that matter
which they, like Simon, looked upon as existing independently[159].
They described this last as separated into four elements, water,
darkness, the abyss, and chaos, which we may suppose to be
different strata of the same substance, the uppermost layer being
apparently the waste of waters mentioned in Genesis. Falling upon
these waters, the superfluity of light of the Holy Spirit stirred them,
although before immovable, to their lowest depths, and took from
them a body formed apparently from the envelope of waters
surrounding it. Then, rising again by a supreme effort from this
contact, it made out of this envelope the visible heaven which has
ever since been stretched over the earth like a canopy[160]. This
superfluity of light which thus mingled with matter, the earlier Ophites
called, like the authors of the Wisdom-literature, Sophia, and also
Prunicos (meaning apparently the “substitute”) and described as
bisexual[161]. Another and perhaps a later modification of their
doctrine fabled that it sprang from the left side of the First Woman
while Christos emerged from her right. They therefore called it
Sinistra and declared it to be feminine only[162]. Both traditions
agreed that this Sophia or Prunicos put forth a son without male
assistance, that this son in like manner gave birth to another power
and so on, until at last seven powers at seven removes sprang from
Sophia. Each of them fashioned from matter a habitation, and these
are represented as heavens or hemispheres stretched out one under
the other, every one becoming less perfect as it gets further from the
Primordial Light[163]. Irenaeus and Hippolytus are agreed that the first
or immediate son of Sophia was called Ialdabaoth, a name which
Origen says, in speaking of the Ophites, is taken from the art of
magic, and which surely enough appears in nearly all the earlier
Magic Papyri[164]. Hippolytus says that this Ialdabaoth was the
Demiurge and father of the visible universe or phenomenal world[165].
Irenaeus also gives the names of the later “heavens, virtues, powers,
angels, and builders” as being respectively Iao, Sabaoth, Adonai,
Eloaeus, Oreus, and Astaphaeus or Astanpheus, which agrees with
the Ophite document or Diagram to be presently mentioned[166]. The
first four of these names are too evidently the names given in the Old
Testament to Yahweh for us to doubt the assertion of the Fathers
that by Ialdabaoth the Ophites meant the God of the Jews[167]. The
last two names, Oreus and Astaphaeus, Origen also asserts to be
taken from the art of magic, and may be supposed to have some
connection with fire and water respectively[168]. It is probable that the
later Ophites identified all these seven heavens with the seven
astrological “planets,” i.e. Saturn, Jupiter, Mars, the Sun, Venus,
Mercury and the Moon in probably that order[169].
How now did the earth on which we live come into being? The
primitive Babylonians, whose ideas and culture were at a very early
date spread over the whole of Asia Minor, conceived the earth not as
a globe but as a circular boat like the ancient coracle, over which the
heavens stretched like a canopy or hemisphere[170]. Hence we must
regard these heavens of the planetary powers, Ialdabaoth and his
progeny, as a series of covers fitting one within the other like, in the
words of the Fathers, “juggling cups,” or to take another simile, the
successive skins of an onion. The earth stretched below these, but
was at the stage of creation at which we have arrived really without
form and void, being the formless waste of waters which covered the
denser darkness and chaos. The ordered shape which it afterwards
assumed and which we now see, was, in the Ophite story, the result
of the fall of no deity, angel, or heavenly power, but of Man. Irenaeus’
account of this Second Fall is that the six powers descended from
Ialdabaoth began to quarrel with their progenitor for supremacy—an
idea which perhaps is to be referred either to the Jewish tradition of
the revolt of the angels or with more likelihood to the astrological
ideas about the benefic and malefic planets[171]. This so enraged him
that he glared in his wrath upon the underlying dregs of matter, and
his thought (ἔννοια) implanted there took birth and shape[172]. This
fresh son of his was possessed of a quality of the possession of
which he himself had never given any evidence, and was called
Nous or Intelligence like the male of Simon’s first syzygy or pair of
roots. But he was said to be of serpent form (ὀφιόμορφος) because,
as says the Naassene or Ophite author quoted by Hippolytus, “the
serpent is the personification of the watery element,” and therefore,
perhaps, the symbol of that external ocean which the ancients
thought surrounded the inhabited world[173]. It seems more probable,
however, that the Ophites were compelled to introduce this form
because the serpent was worshipped everywhere in Asia Minor as
the type of the paternal aspect of the earth-goddess’ consort[174]. This
is best shown, perhaps, in the Eleusinian legend of Zeus and
Persephone; but Alexander himself was said to have been begotten
by Zeus in the form of a serpent, and no Phrygian goddess seems
ever to have been portrayed without one[175]. So much was this the
case that in the Apocryphal Acta Philippi it is said that sacred
serpents were kept in all the heathen temples in Asia. Hierapolis is,
in the same document, called Ophioryma or the serpent’s
stronghold, whence idolatry seems to be spoken of as the Echidna
or Viper[176]. The connection of the serpent with the Sabazian rites
has already been mentioned.
This Ophiomorphus, or god in serpent form, was in the later Ophite
teaching the cause not only of man’s soul but of his passions. The
Latin text of Irenaeus says that from him came “the spirit and the
soul and all earthly things, whence all forgetfulness, and malice, and
jealousy, and envy, and death came into being[177].” This was
evidently written under the influence of the Christian idea that the
serpent of Genesis was Satan or the Devil. But Hippolytus tells us,
no doubt truly, that the Ophiomorphus of the earlier Ophites was in
the opinion of his votaries a benevolent and beneficent power. After
saying that they worship
“nothing else than Naas, whence they are called Naassenes,

and that they say that to this Naas (or serpent) alone is
dedicated every temple, and that he is to be found in every
mystery and initiatory rite,” he continues, “They say that nothing
of the things that are, whether deathless or mortal, with or
without soul, could exist apart from him. And all things are set
under him, and he is good and contains all things within himself,
as in the horn of the unicorn, whence beauty and bloom are
freely given to all things that exist according to their nature and
relationship[178].”
It can hardly be doubted that the writer from whom Hippolytus here
quotes is referring to the soul or animating principle of the world,
whom he here and elsewhere identifies with the great God of the
Greek mysteries[179]. Hence it was the casting-down to this earth of
Ophiomorphus which gave it life and shape, and thus stamped upon
it the impress of the First Man[180]. As Ophiomorphus was also the
child of Ialdabaoth son of Sophia, the Soul of the World might
therefore properly be said to be drawn from all the three visible
worlds[181].
We come to the creation of man which the Ophites attributed to the
act of Ialdabaoth and the other planetary powers, and represented
as taking place not on the earth, but in some one or other of the
heavens under their sway[182]. According to Irenaeus—here our only
authority—Ialdabaoth boasted that he was God and Father, and that
there was none above him[183]. His mother Sophia or Prunicos,
disgusted at this, cried out that he lied, inasmuch as there was
above him “the Father of all, the First Man and the Son of Man[184]”;
and that Ialdabaoth was thereby led on the counsel of the serpent or
Ophiomorphus to say, “Let us make man in our own image[185]!” Here
the Greek or older text of Irenaeus ends, and our only remaining
guide is the later Latin one, which bears many signs of having been
added to from time to time by some person more zealous for
orthodoxy than accuracy. Such as it is, however, it narrates at a
length which compares very unfavourably with the brevity and
concision of the statements of the Greek text, that Ialdabaoth’s six
planetary powers on his command and at the instigation of Sophia
formed an immense man who could only writhe along the ground
until they carried him to Ialdabaoth who breathed into him the breath
of life, thereby parting with some of the light that was in himself; that
man “having thereby become possessed of intelligence (Nous) and
desire (Enthymesis) abandoned his makers and gave thanks to the
First Man”; that Ialdabaoth on this in order to deprive man of the light
he had given him created Eve out of his own desire; that the other
planetary powers fell in love with her beauty and begot from her sons
who are called angels; and finally, that the serpent induced Adam
and Eve to transgress Ialdabaoth’s command not to eat of the fruit of
the Tree of Knowledge[186]. On their doing so, he cast them out of
Paradise, and threw them down to this world together with the
serpent or Ophiomorphus. All this was done by the secret
contrivance of Sophia, whose object throughout was to win back the
light and return it to the highest world whence it had originally come.
Her manner of doing so seems to have been somewhat roundabout,
for it involved the further mingling of light with matter, and even
included the taking away by her of light from Adam and Eve when
turned out of Paradise and the restoring it to them when they
appeared on this earth—a proceeding which gave them to
understand that they had become clothed with material bodies in
which their stay would be only temporary[187]. Cain’s murder of Abel
was brought about by the same agency, as was the begettal of Seth,
ancestor of the existing human race. We further learn that the
serpent who was cast down got under him the angels begotten upon
Eve by the planetary powers, and brought into existence six sons
who, with himself, form “the seven earthly demons.” These are the
adversaries of mankind, because it was on account of man that their
father was cast down; and “this serpent is called Michael and
Sammael[188].” Later Ialdabaoth sent the Flood, sought out Abraham,
and gave the Law to the Jews. In this, as in everything, he was
opposed by his mother Sophia, who saved Noah, made the Prophets
prophesy of Christ, and even arranged that John the Baptist and
Jesus should be born, the one from Elizabeth and the other from the
Virgin Mary[189]. In all this, it is difficult not to see a later interpolation
introduced for the purpose of incorporating with the teaching of the
earlier Ophites the Biblical narrative, of which they were perhaps
only fully informed through Apostolic teaching[190]. It is quite possible
that this interpolation may be taken from the doctrine of the Sethians,
which Irenaeus expressly couples in this chapter with that of the
Ophites, and which, as given by Hippolytus, contains many Jewish
but no Christian features[191]. Many of the stories in this interpolation
seem to have found their way into the Talmud and the later Cabala,
as well as into some of the Manichaean books.
So far, then, the Ophites succeeded in accounting to their
satisfaction for the origin of all things, the nature of the Deity, the
origin of the universe, and for that of man’s body. But they still had to
account in detail for the existence of the soul or incorporeal part of
man. Irenaeus, as we have seen, attributes it to Ophiomorphus, but
although this may have been the belief of the Ophites of his time, the
Naassenes assigned it a more complicated origin. They divided it, as
Hippolytus tells us, into three parts which were nevertheless one, no
doubt corresponding to the threefold division that we have before
seen running through all nature into angelic, psychic, and earthly[192].
The angelic part is brought by Christos, who is, as we have seen, the
angel or messenger of the triune Deity, into “the form of clay[193],” the
psychic we may suppose to be fashioned with the body by the
planetary powers, and the earthly is possibly thought to be the work
of the earthly demons hostile to man[194]. Of these last two parts,
however, we hear nothing directly, and their existence can only be
gathered from the difference here strongly insisted upon between
things “celestial earthly and infernal.” But the conveyance of the
angelic soul to the body Hippolytus’ Ophite writer illustrates by a bold
figure from what Homer in the Odyssey says concerning Hermes in
his character of psychopomp or leader of souls[195]. As to the soul or
animating principle of the world, Hippolytus tells us that the Ophites
did not seek information concerning it and its nature from the
Scriptures, where indeed they would have some difficulty in finding
any, but from the mystic rites alike of the Greeks and the
Barbarians[196]; and he takes us in turns through the mysteries of the
Syrian worshippers of Adonis, of the Phrygians, the Egyptian (or
rather Alexandrian) worshippers of Osiris, of the Cabiri of
Samothrace, and finally those celebrated at Eleusis, pointing out
many things which he considers as indicating the Ophites’ own
peculiar doctrine on this point[197]. That he considers the god
worshipped in all these different mysteries to be one and the same
divinity seems plain from a hymn which he quotes as a song of “the
great Mysteries,” and which the late Prof. Conington turned into
English verse[198]. So far as any sense can be read into an
explanation made doubly hard for us by our ignorance of what really
took place in the rites the Ophite writer describes, or of any clear
account of his own tenets, he seems to say that the many apparently
obscene and sensual scenes that he alludes to, cover the doctrine
that man’s soul is part of the universal soul diffused through Nature
and eventually to be freed from all material contact and united to the
Deity; whence it is only those who abstain from the practice of carnal
generation who can hope to be admitted to the highest heaven[199].
All this is illustrated by many quotations not only from the heathen
poets and philosophers, but also from the Pentateuch, the Psalms,
the Jewish Prophets, and from the Canonical Gospels and St Paul’s
Epistles.
The connection of such a system with orthodox Christianity seems at
first sight remote enough, but it must be remembered that Hippolytus
was not endeavouring to explain or record the Ophite beliefs as a
historian would have done, but to hold them up to ridicule and, as he
describes it, to “refute” them. Yet there can be no doubt that the
Ophites were Christians or followers of Christ who accepted without
question the Divine Mission of Jesus, and held that only through Him
could they attain salvation. The difference between them and the
orthodox in respect to this was that salvation was not, according to
them, offered freely to all, but was on the contrary a magical result
following automatically upon complete initiation and participation in
the Mysteries[200]. Texts like “Strait is the way and narrow is the gate
that leadeth into eternal life” and “Not every one that saith unto me
Lord, Lord, shall enter into the kingdom of heaven” were laid hold of
by them as showing that complete salvation was confined to a few
highly instructed persons, who had had the sense to acquire the
knowledge of the nature of the Deity and of the topography of the
heavenly places which underlay the ceremonies of the Mysteries.
Such an one, they said after his death would be born again not with
a fleshly but with a spiritual body and passing through the gate of
heaven would become a god[201]. It does not follow, however, that
those who did not obtain this perfect gnosis would be left, as in some
later creeds, to reprobation. The cry of “all things in heaven, on
earth, and below the earth[202]” that the discord of this world[203] might
be made to cease, which the Naassene author quoted by Hippolytus
daringly connects with the name of Pappas given by the Phrygians
to Sabazius or Dionysos, would one day be heard, and the
Apocatastasis or return of the world to the Deity would then take
place[204]. If we may judge from the later developments of the Ophite
teaching this was to be when the last spiritual man (πνευματικός) or
perfect Gnostic had been withdrawn from it. In the meantime those
less gifted would after death pass through the planetary worlds of
Ialdabaoth until they arrived at his heaven or sphere, and would then
be sent down to the earth to be reincarnated in other bodies.
Whether those who had attained some knowledge of the Divine
nature without arriving at perfect Gnosis would or would not be
rewarded with some sort of modified beatitude or opportunity of
better instruction is not distinctly stated, but it is probable that the
Ophites thought that they would[205]. For just as those who have been
admitted into the Lesser Mysteries at Eleusis ought to pause and
then be admitted into the “great and heavenly ones,” the progress of
the Ophite towards the Deity must be progressive. They who
participate in these heavenly mysteries, says the Naassene author,
receive greater destinies than the others[206].
It might seem, therefore, that the Mysteries or secret rites of the
heathens contained in themselves all that was necessary for
redemption, and this was probably the Ophite view so far as the
return of the universe to the bosom of the Deity and the consequent
wiping out of the consequences of the unfortunate fall of Sophia or
Prunicos were concerned. A tradition. preserved by Irenaeus says
that Sophia herself “when she had received a desire for the light
above her, laid down the body she had received from matter—which
was, as we have seen, the visible heaven—-and was freed from
it[207].” But this seems to be an addition which is not found in the
Greek version, and is probably taken from some later developments
of the Ophite creed. It is plain, however, that the whole scheme of
nature as set forth in the opinions summarized above is represented
as contrived for the winning-back of the light—for which we may, if
we like, read life—from matter, and this is represented as the work of
Sophia herself. The futile attempt of the arrogant and jealous
Ialdabaoth to prolong his rule by the successive creation of world
after world, of the archetypal or rather protoplasmic Adam, and
finally of Eve, whereby the light is dispersed through matter more
thoroughly but in ever-diminishing portions[208], is turned against him
by his mother Sophia, the beneficent ruler of the planetary worlds,
who even converts acquaintance with the “carnal generation” which
he has invented into a necessary preparation for the higher
mysteries[209]. Thus Hippolytus tells us that the Naassenes
“frequent the so-called mysteries of the Great Mother, thinking

that through what is performed there, they see clearly the whole
mystery. For they have no complete advantage from the things
there performed except that they are not castrated. [Yet] they
fully accomplish the work of the castrated [i.e. the Galli]. For they
most strictly and carefully preach that one should abstain from all
companying with woman, as do the castrated. And the rest of the
work, as we have said at length, they perform like the
castrated[210].”
So far, then, as the general scheme of the redemption of light from

matter is concerned, there seems to have been no fundamental
necessity in the Ophite view for the Mission of Jesus. But they
assigned to Him a great and predominant part in hastening the
execution of the scheme, and thus bringing about the near approach
of the kingdom of heaven. We have seen that Sophia provided in
spite of Ialdabaoth for the birth of the man Jesus from the Virgin
Mary, and the Naassene author said that
“into this body of Jesus there withdrew and descended things

intellectual, and psychic, and earthly: and these three Men (i.e.
the First Man, the Son of Man, and Christos) speak together
through Him each from his proper substance unto those who
belong to each[211].”
The Latin text of Irenaeus amplifies the statement considerably and

says that Prunicus, as it calls Sophia, finding no rest in heaven or
earth, invoked the aid of her mother the First Woman. This power,
having pity on her repentance, implored the First Man to send
Christos to her assistance. This prayer was granted, and Christos
descended from the Pleroma to his sister Sophia, announced his
coming through John the Baptist, prepared the baptism of
repentance, and beforehand fashioned Jesus, so that when Christos
came down he might find a pure vessel, and that by Ialdabaoth her
own son, the “woman” might be announced by Christ. The author
quoted by Irenaeus goes on to say that Christ descended through
each of the seven heavens or planetary worlds in the likeness of its
inhabitants, and thus took away much of their power. For the
sprinkling of light scattered among them rushed to him, and when he
came down into this world he clothed his sister Sophia with it, and
they exulted over each other, which they (the Ophites) “describe as
the [meeting of] the bridegroom and the bride.” But “Jesus being
begotten from the Virgin by the operation of God was wiser, purer,
and juster than all men. Christos united to Sophia descended into
Him [in His baptism] and so Jesus Christ was made[212].”
Jesus then began to heal the sick, to announce the unknown Father,
and to reveal Himself as the Son of the first man. This angered the
princes of the planetary worlds and their progenitor, Ialdabaoth, who
contrived that He should be killed. As He was being led away for this
purpose, Christos with Sophia left Him for the incorruptible aeon[213]
or highest heaven. Jesus was crucified; but Christos did not forget
Him and sent a certain power to Him, who raised Him in both a
spiritual and psychic body, sending the worldly parts back into the
world. After His Resurrection, Jesus remained upon earth eighteen
months, and perception descending into Him taught what was clear.
These things He imparted to a few of his disciples whom He knew to
be capable of receiving such great mysteries, and He was then
received into heaven. Christos sate down at the night hand of
Ialdabaoth that he might, unknown to this last, take to himself the
souls of those who have known these mysteries, after they have put
off their worldly flesh. Thus Ialdabaoth cannot in future hold holy
souls that he may send them down again into the age [i.e. this aeon];
but only those which are from his own substance, that is, which he
has himself breathed into bodies. When all the sprinkling of light is
thus collected, it will be taken up into the incorruptible aeon. The
return to Deity will then be complete, and matter will probably be
destroyed. In any case, it will have lost the light which alone gives it
life[214].
What rites or form of worship were practised by these Ophites we do
not know, although Epiphanius preserves a story that they were in
the habit of keeping a tame serpent in a chest which at the moment
of the consecration of their Eucharist was released and twined itself
round the consecrated bread[215]. Probably the very credulous Bishop
of Constantia was misled by some picture or amulet depicting a
serpent with his tail in its mouth surrounding an orb or globe which
represents the mundane egg of the Orphics. In this case the serpent
most likely represented the external ocean which the ancients
thought surrounded the habitable world like a girdle. But the story,
though probably untrue, is some evidence that the later Ophites
used, like all post-Christian Gnostics, to practise a ceremony
resembling the Eucharist, and certainly administered also the rite of
baptism which is alluded to above in the tale of the descent of
Christos. Hippolytus also tells us that they used to sing many hymns
to the First Man; and he gives us a “psalm” composed by them
which, as he thinks, “comprehends all the mysteries of their
error[216].” Unfortunately in the one text of the Philosophumena which
we have, it is given in so corrupt a form that the first German editor
declared it to be incapable of restoration. It may perhaps be
translated thus:
The generic law of the Whole was the first Intelligence of all
The second [creation?] was the poured-forth Chaos of the
First-born
And the third and labouring soul obtains the law as her
portion
Wherefore clothed in watery form [Behold]
The loved one subject to toil [and] death
Now, having lordship, she beholds the Light
Then cast forth to piteous state, she weeps.
Now she weeps and now rejoices
Now she weeps and now is judged
Now she is judged and now is dying
Now no outlet is found, the unhappy one
Into the labyrinth of woes has wandered.
But Jesus said: Father, behold!
A strife of woes upon earth
From thy spirit has fallen
But he [i.e. man?] seeks to fly the malignant chaos
And knows not how to break it up.
For his sake, send me, O Father;
Having the seals, I will go down
Through entire aeons I will pass,
All mysteries I will open
And the forms of the gods I will display,
The secrets of the holy Way
Called knowledge [Gnosis], I will hand down.
It is probable that this psalm really did once contain a summary of

the essential parts of the Ophite teaching. In whatever way we may
construe the first three lines, which were probably misunderstood by
the scribe of the text before us, there can hardly be a doubt that they
disclose a triad of three powers engaged in the work of salvation[217].
The fall of Sophia seems also to be alluded to in unmistakable terms,
while the Mission of Jesus concludes the poem. Jesus, not here
distinguished from the Christos or Heavenly Messenger of the Trinity,
is described as sent to the earth for the purpose of bringing hither
certain “mysteries” which will put man on the sacred path of Gnosis
and thus bring about the redemption of his heavenly part from the
bonds of matter. These “mysteries” were, as appears in Hippolytus
and elsewhere, sacraments comprising baptism, unction, and a
ceremony at least outwardly resembling the Christian Eucharist or
Lord’s Supper[218]. These had the magical effect, already attributed
by the Orphics to their own homophagous feast, of changing the
recipient’s place in the scale of being and transforming him ipso
facto into something higher than man. That the celebration of these
mysteries was attended with the deepest secrecy accounts at once
for their being nowhere described in detail by Hippolytus’ Ophite
author, and also for the stories which were current among all the
heresiological writers of filthy and obscene rites[219]. Fortified by
these mysteries, and by the abstinences and the continence which
they entailed—at all events theoretically, and as a counsel of
perfection—the Ophite could attend, as we have seen, all the
ceremonies of the still pagan Anatolians or of the Christian Church
indifferently, conscious that he alone understood the inner meaning
of either.
Another practice of the Ophites has accidentally come down to us
which deserves some mention. The division of the universe into
three parts, i.e. angelic, psychic, and earthly, which we have already
seen in germ in the system of Simon Magus, was by the Ophites
carried so much further than by him that it extended through the
whole of nature, and seriously affected their scheme of redemption.
Father Giraud, as we have seen, goes so far as to say that in the
opinion of Naassenes, matter hardly existed, and that they thought
that not only did Adamas, or the first man, enter into all things, but
that in their opinion all things were contained within him[220]. This
pantheistic doctrine may have been current in Phrygia and traces of
it may perhaps be found in the Anatolian worship of nature; but the
words of the Naassene psalm quoted above show that the
Naassenes, like all the post-Christian Gnostics of whom we know
anything, thought that matter not only had an independent existence,
but was essentially malignant and opposed to God. They divided, as
we have seen, the universe which came forth from Him into three
parts of which the angelic, noëtic, or pneumatic included, apparently,
nothing but the Pleroma or Fulness of the Godhead consisting of the
Trinity of Father, Son and Mother with their messenger Christos.
Then followed the second, psychic, or planetary world, containing
the heaven of Sophia with beneath it the holy hebdomad or seven
worlds of Ialdabaoth and his descendants[221]. Below this came,
indeed, the choïc, earthly, or terrestrial world, containing some
sparks of the light bestowed upon it consciously by Sophia and
unconsciously by Ialdabaoth, and inhabited by mortal men. But this
world was the worst example of the “discord” (ὰσυμφωνία), or as it
was called later, the “confusion” (κέρασμος), caused by the mingling
of light with matter, and as such was doomed to extinction and to
eternal separation from the Divine.[222] In like manner, the soul of
man consisted of three parts corresponding to the three worlds, that
is to say, the pneumatic, psychic, and earthly; and of these three, the
last was doomed to extinction. Only by laying aside his earthly part
as Jesus had done and becoming entirely pneumatic, could man
attain to the light and become united with the Godhead. But to do so,
his soul must first pass from choïc to psychic and thence to
pneumatic, or, as the Naassene author quoted by Hippolytus puts it,
must be born again and must enter in at the gate of heaven[223].
This rebirth or passage of the soul from the choïc to the psychic, and
thence to the pneumatic, was, as has been said, the work of the
mysteries, especially of those new ones which the Ophite Jesus or
Christos had brought to earth with Him from above. The process by
which these “changes of the soul” were brought about was,
according to the Naassenes, “set forth in the Gospel according to the
Egyptians[224].” The only quotation pertinent to the matter which we
have from this lost work is one preserved for us by Clement of
Alexandria which refers to the coming of a heavenly age “when the
two shall be made one, and the male with the female neither male
nor female[225]”—a saying which seems to refer to the time when all
the light now scattered among the lower worlds shall return to the
androgyne Adamas from whom it once issued. But it is probable that
this gospel only described the upward passage of the soul in figures
and parables probably conveyed in texts of the Canonical Gospel
divorced from their context and their natural meaning, as in the
Naassene author quoted by Hippolytus. Such a gospel might be a
sufficient means of instruction for the living, who could puzzle out its
meaning with the help of their mystagogues or priests[226]; but it must
always have been difficult for the best-instructed to remember the
great complications of worlds, planets, and celestial powers that lay
at the root of it. How difficult then must it have been thought for the
disembodied soul to find its way through the celestial places, and to
confront the “guardians of the gate” of each with proof of his exalted
rank in the scale of being? What was wanted was some guide or
clue that the dead could take with him like the Book of the Dead of
the ancient Egyptians, some memory or survival of which had
evidently come down to the Alexandrian worship[227], or like the gold
plates which we have seen fulfilling the same office among the
worshippers of the Orphic gods[228].
That the Ophites possessed such documents we have proof from the
remarks of the Epicurean Celsus, who may have flourished in the
reign of Hadrian (A.D. 117-138)[229]. In his attack on Christianity called
The True Discourse, he charges the Christians generally with
possessing a “diagram” in which the passage of the soul after death
through the seven heavens is portrayed. Origen, in refuting this
Epicurean’s arguments more than a century later, denies that the
Church knew anything of such a diagram, and transfers the
responsibility for it to what he calls “a very insignificant sect called
Ophites[230].” He further says that he has himself seen this diagram
and he gives a detailed description of it sufficient to enable certain
modern writers to hazard a guess as to what it must have looked
like[231]. It seems to have been chiefly composed of circles, those in
the uppermost part—which Celsus says were those “above the
heavens”—being two sets of pairs. Each pair consisted of two
concentric circles, one pair being inscribed, according to Origen,
Father-and-Son, and according to Celsus, “a greater and a less”
which Origen declares means the same thing[232]. By the side of this
was the other pair, the outer circle here being coloured yellow and
the inner blue; while between the two pairs was a barrier drawn in
the form of a double-bladed axe[233].
“Above this last” Origen says “was a smaller circle inscribed

‘Love,’ and below it another touching it with the word ‘Life.’ And
on the second circle, which was intertwined with and included
two other circles, another figure like a rhomboid ‘The
Forethought of Sophia.’ And within their (?) point of common
section was ‘the Nature of Sophia.’ And above their point of
common section was a circle, on which was inscribed
‘Knowledge,’ and lower down another on which was the
inscription ‘Comprehension[234].’”
There is also reference made by Origen to “The Gates of Paradise,”

and a flaming sword depicted as the diameter of a flaming circle and
guarding the tree of knowledge and of life; but nothing is said of their
respective places in the diagram.
Jacques Matter, whose Histoire Critique du Gnosticisme appeared in
1843, without its author having the benefit of becoming acquainted
with Hippolytus’ Philosophumena, which tells us so much as to the
doctrines of the Naassenes or early Ophites, and Father Giraud, who
has on the contrary drawn largely from it, and whose dissertation on
the Ophites was published in 1884, have both given pictorial
representations of the Ophite diagram. Although they differ
somewhat in the arrangement of the circles, both are agreed that the
blue and yellow circles signify the Holy Spirit and Christos. The
Pleroma or Fulness of the Godhead consisting of Father, Son and
Holy Spirit, with the Christos their messenger, therefore seems
figured in these two pairs of circles. Both Matter and Father Giraud
also arrange four other circles labelled respectively Knowledge,
Nature, Wisdom, and Comprehension (Γνῶσις, Φύσις, Σοφία, and
Σύνεσις) within one large one with a border of intertwined lines which
they call the Forethought of Sophia (Πρόνοια Σοφίας). This may be
the correct rendering, but it is hardly warranted by Origen’s words
given above, nor do we know of any powers, aeons, or other entities
in the Ophite system called Gnosis or Physis[235]. In any event,
however, it is fairly clear that this part of the diagram represents the
Sophia who fell from the Holy Spirit into matter, and that her natural
or first place should be the heaven stretched out above the seven
planetary worlds. Yet Irenaeus tells us that the Ophites he describes
thought that Sophia succeeded finally in struggling free from the
body of matter and that the super-planetary firmament represented
merely the lifeless shell she had abandoned[236]. This is, perhaps, the
view taken by the framers of the diagram.
However that may be, Origen’s discourse agrees with Celsus in
describing a “thick black line marked Gehenna or Tartarus” which
cuts, as he says, the diagram in two. This is specially described by
Celsus; and if it surprises anyone to find it thus placed above the
planetary heavens, it can only be said that later Gnostics, including
those who are responsible for the principal documents of the Pistis
Sophia to be presently mentioned, put one of the places where souls
were tortured in “the Middle Way” which seems above, and not, like
the classical Tartarus, below the earth[237]. Below this again, come
the seven spheres of the planets dignified by the names of Horaios,
Ailoaios, Astaphaios, Sabaoth, Iao, Ialdabaoth and Adonai
respectively. These names are, indeed, those given in Irenaeus as
the names of the descendants of Sophia, although the order there
given is different. As to the meaning of them, Origen declares that
Ialdabaoth, Horaios, and Astaphaios are taken from magic and that
the others are (the Hebrew) names of God[238]. But it should be
noticed that Origen is in this place silent as to their situation in the
diagram, and that those assigned to them in Matter’s and Father
Giraud’s reconstructions are taken from the prayers or “defences”
which will be given independently of it.
The division which Matter calls “Atmosphère terrestre” and Father
Giraud “The Fence of Wickedness” (Φραγμὸς Κακίας) is also not to
be found in Origen’s description of the diagram, but is taken from
another passage where he defines it as the gates leading to the
aeon of the archons[239]. The remaining sphere, containing within
itself ten circles in Matter’s reconstruction and seven in Father
Giraud’s, is however fully described. The number ten is, as Matter
himself admitted to be probable, a mistake of the copyist for
seven[240], and there can be no doubt that the larger sphere is
supposed to represent our world. The word “Leviathan” which in
accordance with Origen’s description is written both at the
circumference and at the centre of the circle[241] is evidently
Ophiomorphus or the serpent-formed son of Ialdabaoth whom we
have seen cast down to earth by his father together with the
protoplasts Adam and Eve[242]. He should according to the later
Gnostics be represented in the shape of a “dragon” or serpent coiled
round the world and having his tail in his mouth, while the seven
circles within the ring thus formed are the seven Archons or ruling
spirits created by him in imitation of Ialdabaoth. These are
represented in beast-like form and are, as we have seen, hostile to
man. The first four have the Hebrew angelic names of Michael,
Suriel, Raphael, and Gabriel, perhaps because the four planetary
worlds to which they correspond bear also Hebrew names of
God[243]. The remaining three Thauthabaoth, Erataoth, and
Thartharaoth are probably taken from the peculiar corruption of
Hebrew and Egyptian words to be found in the Magic Papyri. Some
of them, at any rate, we meet again later. The word Behemoth which
appears at the foot of the diagram may be translated “animals[244].” It
may either be a further description of the seven Archons—as seems
most likely—or be taken in its etymological sense as the animal
kingdom which in the scale of being succeeds terrestrial man.
To this diagram, Origen adds the prayers or defences above alluded
to, which he draws from some source not mentioned. He calls them
the “instruction” which they (i.e. the Ophites) receive after passing
through the “fence of wickedness,—gates which are subjected to the
world of the Archons[245]”; but we know from other sources that they
are the speeches, “defences” or passwords required to be uttered by
the soul of the initiated when, released from this world by death, she
flies upwards through the planetary spheres[246]. As they contain
many instructive allusions, they can best be given in Origen’s own
words, at the same time remarking that the reading is not in all cases
very well settled. The first power through whose realm the soul had
to pass is not here mentioned by name, but by the process of
exhaustion is plainly the one whom Irenaeus calls Adonaeus or
Adonai.
To him the soul of the dead is to say:
“I salute the one-formed king, the bond of blindness, thoughtless

oblivion, the first power preserved by the spirit of Pronoia and by
Sophia; whence I am sent forth pure, being already part of the
light of the Son and of the Father. Let grace be with me, O
Father, yea let it be with me[247]!”
In passing through the next mentioned, which is the realm of

Ialdabaoth:
“Thou O First and Seventh, born to command with boldness,

Ialdabaoth the Ruler (Archon) who hast the word of pure Mind
(νοῦς), a perfect work to the Son and the Father, I bring the
symbol of life in the impress of a type, and open the door to the
world which in thy aeon thou didst close, and pass again free
through thy realm. Let grace be with me, O Father, yea let it be
with me[248]!”
Arrived at Iao, he ought to say:

“Thou, O Second Iao and first lord of death, who dost rule over
the hidden mysteries of the Son and the Father, who dost shine
by night, part of the guiltless one. I bear my own beard as a
symbol and am ready to pass through thy rule, having been
strengthened by that which was born from thee by the living
word. Let grace be with me, O Father, yea let it be with me[249]!”
To Sabaoth:
“Ruler of the Fifth realm, King Sabaoth, advocate of the law of

thy creation. I am freed by grace of a mightier Pentad. Admit me,
when thou beholdest the blameless symbol of thy art preserved
by the likeness of a type, a body set free by a pentad. Let grace
be with me, O Father, yea let it be with me[250]!”
To Astaphaios:
“Ὁ Astaphaios, Ruler of the third gate, overseer of the first

principle of water, behold me an initiate, admit me who have
been purified by the spirit of a virgin, thou who seest the
substance of the Cosmos. Let grace be with me, O Father, yea
let it be with me[251]!”
To Ailoaios:
“O Ailoaios, ruler of the second gate, admit me who brings to

thee the symbol of thy mother, a grace hidden from the powers
of the authorities. Let grace be with me, O Father, yea let it be
with me[252]!”
and to Horaios:
“O Horaios, who didst fearlessly overleap the fence of fire

receiving the rulership of the first gate, admit me when thou
beholdest the symbol of thy power, engraved on the type of the
Tree of Life, and formed by resemblance in the likeness of the
Guiltless One. Let grace be with me, O Father, yea let it be with
me[253]!”

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LONDON AND NEW YORK

Notes on the text

First published in 2016 by Speechmark Publishing Ltd

Published 2017 by Routledge

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright © Maggie Johnson & Alison Wintgens, 2016

British Library Cataloguing in Publication Data

ISBN 978 1 90930 133 7 (pbk)

Part 1 Understanding Selective Mutism

Part 2 Guidelines for Identification and Assessment

Part 4 Reflective Practice: Learning from Experience

Part 5 Online Resource Library

Appendix C Examples of programme targets, recording systems and individual

This book contains a wealth of knowledge!

Hanne Kristensen, MD, PhD

Maggie Johnson and Alison Wintgens

6.1 Confident talking – the stages of one-to-one interaction related to assessment 96

7.1 The progressions of confident talking 108

8.1 Confident talking – building rapport on a one-to-one basis 124

8.2 Possible maintaining factors with alternative management strategies  134

9.1 Confident talking – establishing speech on a one-to-one basis through shared

9.2 Talking in public places – community settings 167

10.1 Summary of low- and high-risk activities 178

10.3 Confident talking – establishing speech on a one-to-one basis through friends

10.4 Classification of activities by level of risk (anxiety load) 193

10.5 Talking in public places – educational settings 205

10.6 Confident talking – working towards effective social functioning 211

10.7 Categorisation of unhelpful thinking patterns 228

10.8 Reframing unhelpful thoughts 229

2.2 Summary of factors contributing to the development of selective mutism 37

2.3 How pressure and avoidance contribute to selective mutism  40

2.4 Development and implementation of an effective multi-agency care

2.5 A multidimensional model of confident talking 47

3.1 Flow chart for lay diagnosis of selective mutism 57

3.2 The assessment framework 60

5.1 Making a talking map 77

5.2 ‘The best school in the world’ 78

5.3 Learning about phobias 83

5.4 ‘Kitten Phobia’ by Greg Sherrer 84

5.5 Establishing a young person’s priorities 88

5.6 Establishing priorities, using sorting and ranking 89

5.7 Exploring the young person’s self-perception, using a rating activity 91

7.1 Planning intervention: overall strategy and team building  105

7.2 Confident talking – a model for balanced intervention 106

7.3 Confident talking – the generalisation process 107

8.1 Drawing up an action plan 116

8.2 Selective mutism awareness cards  118

8.3 Examples of pictorial rating scales to express emotions 126

8.4 Communication chart  127

8.5 Working towards initiating contact at school 128

8.6 What are you thinking? 132

6.1 Confident talking – the stages of one-to-one interaction related to assessment 96

7.1 The progressions of confident talking 108

8.1 Confident talking – building rapport on a one-to-one basis 124

8.2 Possible maintaining factors with alternative management strategies 134

9.2 Talking in public places – community settings 167

10.1 Summary of low- and high-risk activities 178

10.4 Classification of activities by level of risk (anxiety load) 193

10.5 Talking in public places – educational settings 205

10.6 Confident talking – working towards effective social functioning 211

10.7 Categorisation of unhelpful thinking patterns 228

10.8 Reframing unhelpful thoughts 229

2.2 Summary of factors contributing to the development of selective mutism 37

2.3 How pressure and avoidance contribute to selective mutism 40

2.5 A multidimensional model of confident talking 47

3.1 Flow chart for lay diagnosis of selective mutism 57

3.2 The assessment framework 60

5.1 Making a talking map 77

5.2 ‘The best school in the world’ 78

5.3 Learning about phobias 83

5.4 ‘Kitten Phobia’ by Greg Sherrer 84

5.5 Establishing a young person’s priorities 88

5.6 Establishing priorities, using sorting and ranking 89

5.7 Exploring the young person’s self-perception, using a rating activity 91

7.1 Planning intervention: overall strategy and team building 105

7.2 Confident talking – a model for balanced intervention 106

7.3 Confident talking – the generalisation process 107

8.1 Drawing up an action plan 116

8.2 Selective mutism awareness cards 118

8.3 Examples of pictorial rating scales to express emotions 126

8.4 Communication chart 127

8.5 Working towards initiating contact at school 128

8.6 What are you thinking? 132

9.2 Introducing questions to a person with selective mutism 153

9.3 Using a talking bridge to accelerate one-to-one interaction 153

9.4 The Triangle Tactic 156

10.1 The mechanics of voice production 218

10.3 Exploring communication styles 224

11.1 Introducing a child who has selective mutism 237

Box 2.3 Avoidance behaviour in SM 35

Box 2.4 Summary of SM maintaining factors 39

Box 7.1 Overall management progression 103

Box 9.1 Fostering friendships 154

Box 9.2 Example of telephone homework 165

Box 10.1 Home visits for younger children 181

Box 10.2 What makes a good keyworker? 189

Box 10.3 ‘My Story’ script 208

3 Record of speaking habits 548